The No Surprises Act in 2026: What Practices Need to Know About IDR, QPA & Compliance
IDR volume has doubled, providers win ~88% of disputes, and a 2026 final rule just cut the filing fee to $15. What the No Surprises Act means for your practice now.
Family Practice Medical Billing Services: Stop Leaving Revenue on the Table
Modifier 25, the G2211 add-on, and Chronic Care Management are where family practices quietly lose — and recover — thousands each month. Here’s how.
CARC and RARC Codes: The Full Searchable Table (2026)
Searchable tables of all CARC codes and RARC codes, current and deactivated, from the X12 lists dated 11/1/2025 and 7/1/2026, plus ten denial codes to fix.
Physician Credentialing Services: What’s Included and When to Outsource
Physician credentialing services handle the verification and paperwork that let a physician see patients and get paid: primary-source verification of…
Texas Provider Credentialing and Enrollment: TSCA, TMHP and Payer Rules
Quick answer In Texas, physician credentialing by hospitals, HMOs and PPOs runs on the Texas Standardized Credentialing Application (TDI form LHL234); Medicaid enrollment goes through TMHP, with separate contracting for each Medicaid managed-care plan; and a physician joining an established group can be paid as in-network while credentialing under Texas Insurance Code chapter 1452, subchapter […]
Why CPT 59400 Global OB Claims Deny — and What Changes in 2027
Quick answer CPT 59400 is the global vaginal-delivery obstetric package — antepartum care, delivery and postpartum care by the same physician or group. Most denials happen when the global package is billed for a pregnancy the practice did not manage end to end. From 1/1/2027 the global packages are deleted entirely. When care is split, […]
Why CPT 76801 and 76817 OB Ultrasound Claims Deny
Quick answer CPT 76801 is the first-trimester (before 14 weeks 0 days) transabdominal obstetric ultrasound and 76817 is the transvaginal obstetric ultrasound. Most denials come from stacking the two without documentation, missing the additional-gestation add-ons, or billing 76811 without a high-risk indication. 76817 may be reported with a transabdominal exam only when both approaches are […]
Why CPT 75574 CCTA Claims Deny
Quick answer CPT 75574 is coronary CT angiography — CT of the heart, coronary arteries and bypass grafts with contrast, including image post-processing and quantitative evaluation of coronary calcium when performed. Most denials are coverage and documentation failures, not coding errors. Because 75574 already includes calcium evaluation when performed, 75571 is not separately reported for […]
Getting Ahead of Deductible Season: A Q4 Playbook
Get ahead of deductible season by tightening four things before January: run real-time eligibility checks on every visit, collect patient responsibility…
The 2026 Guide to Telehealth Billing Codes
Get clear answers on telehealth billing codes, new CPT updates, and payer rules so your practice can bill virtual visits accurately and avoid claim denials.
What Medical Billing Companies Actually Charge
Medical billing companies charge under one of three models: a percentage of collections, a flat monthly fee, or a per-claim fee — often with setup charges…
Hospital Medical Billing Services: Facility vs. Professional Billing Explained
Inpatient E/M, observation packaging, discharge codes, and the 2026 OPPS changes — what practice managers need to know about hospital and facility billing.